The mortality rate in patients with acute renal failure requiring dialysis is high. Estimation of a patient's mortality risk can aid decision-making.
Patient population: Patients with acute renal failure whose urine output does not respond to a single dose of furosemide 15 mg/kg.
The SAPS (simplified acute physiology score) correlates with prognosis).
|
SAPS |
mortality rate |
|
<= 15 |
22% |
|
> 15 |
65% |
Adverse risk factors in patients being dialyzed for acute renal failure:
(1) age > 55 years
(2) need for mechanical ventilation or CPAP at any time before end of dialysis period
(3) urine volume < 500 mL per day before or on the fifth day of admission
(4) sepsis
(5) shock
(6) bilirubin > 30 µmol/L (1.75 mg/dL)
Simple interpretation (overall risk)
|
number of risk factors |
mortality rate |
|
3 |
32% |
|
4 |
70% |
|
5 |
81% |
|
6 |
100% |
Specific patterns (best and worst combinations)
|
number factors |
age |
ventila-tion |
urinary volume |
sepsis |
shock |
bili-rubin |
mortal-ity rate |
|
3 |
Y |
Y |
N |
N |
Y |
N |
25% |
|
3 |
N |
N |
Y |
Y |
N |
Y |
56% |
|
4 |
Y |
Y |
N |
N |
Y |
Y |
53% |
|
4 |
Y |
N |
Y |
Y |
N |
Y |
80% |
|
5 |
Y |
Y |
Y |
N |
Y |
Y |
84% |
|
5 |
Y |
Y |
Y |
Y |
N |
Y |
92% |
|
6 |
Y |
Y |
Y |
Y |
Y |
Y |
96% |
Specialty: Nephrology, Clinical Laboratory
